15 thoughts on “Don’t Call it Hypersexuality: Why we Need the Term Sex Addiction

  • July 24, 2013 at 11:58 am

    I think you’re being unnecessarily hard on the researchers, instead of on the popular press that is jumping all over these results for the sake of sensationalism.

    Here’s the lead researcher herself, Dr. Nicole Prause, on the import of the findings, from an interview at http://www.psychologytoday.com. Prause runs an addictionology lab at UCLA that looks at all addictions, not just sex:

    Q. What does this mean for those in treatment for sex addiction now?

    A. “Nothing. The study needs to be replicated. Alternative explanations need to be explored. If the wrong model is currently being used to provide treatments, we must find the right model to help people struggling with their sexual behaviors. We’re working on it!”


    Who could be against what Prause is arguing for, or her humility and attachment to scientific method, including the embrace of attempts to embrace a null hypothesis? Kudos are due to her and her lab.

    • July 24, 2013 at 3:12 pm

      This study is a joke.

      1) The authors manipulated data to produce their single correlation: EEG readings with sexual desire. They created this imaginary correlation by omitting questions from a standardized test called the “sexual desire inventory” (SDI).

      In fact, the creator of the SDI (Ilana Spector) stated that researchers misused the test because omitted all the questions about masturbation – the very activity subjects had trouble controlling.

      QUOTE from Ilana Spector, the creator of the (SDI)

      “The scale was only validated using ALL the items both solitary and dyadic…. The scale was not designed to be used [as it was here] nor was it validated that way.”

      No correlation = no headlines.

      2) In addition, several of the subjects were not heterosexual, yet all subjects were shown the same pictures – heterosexual sex. Does anyone think that a gay man will have the same response to heterosexual porn as a straight man? Dopes a straight man have the same responese as a women? No wonder their scores didn’t correlate with anything.

      3) The authors had no control group, so they have no idea if the response was normal or not. This alone discredits this study.

      4) Unlike other addiction studies, they did not pre-screen subjects for addiction. In fact, the authors admitted that some subjects had severe problems, while others had few problems with porn. No wonder the scores didn’t correlate with anything.

      Google – “UCLA’s SPAN Lab Touts Empty Porn Study As Ground-Breaking” – for complete refutation of this bogus study.

      • July 25, 2013 at 1:07 pm

        A more measured response from a Ph.D. neuroscientist and associate professor at Wheaton College:

        “The study by Steele, Staley, Fong and Prause is an important first step in filling in the picture of what many refer to as sex addiction, and the authors are incredibly generous, cautious, and thoughtful in their writing and interpretation of the results. Underneath it all, the process of science continues and informs the language that we use to engage the mental health issues that need to be addressed.”


      • July 25, 2013 at 3:16 pm

        Hardly generous and thoughtful. Rather than reconsidering their unsupported conclusions they are dodging the very widespread and thoughtful criticisms by other experts while still staying in the public eye. Science can in the long run inform language but not in the way this study attempts to do.

    • July 28, 2013 at 3:04 pm

      I don’t think it’s right to simply blame the media for the sensationalism.

      This study was provided to an anti-sex-addiction polemicist months before it was published in a journal. He predictably then wrote a blog post about how the study conclusively disproves sex addiction.

  • July 25, 2013 at 5:02 pm

    Dr. Hatch is spot on about dodging, but it is now more than that. It’s behind the scenes maneuvering and God knows what else.

    This Psychology Today blog “Misinformed Media Touts Bogus Sex Addiction Study, by Robert Weiss, LCSW & Stefanie Carnes PhD” was deleted this morning. Thsi is the second Psychology Today post about this study that has been deleted. What’s going on here?

    See both blog posts at –



    • July 25, 2013 at 11:23 pm

      That’s weird, that they took those blogs down. Has any Ph.D.-level neuropsychology researcher published anything as critical as in those two links?

      • July 25, 2013 at 11:56 pm

        My colleagues who are keeping track tell me there is a lot of criticism from various directions. The entire back story on the great Prause debate may come clear in time, or may not. But research will go on and sex addiction treatment will go on.

  • July 26, 2013 at 9:47 am

    When a Ph.D.-level neuroscientist publishes a critique, please post it? Maybe one of your colleagues could send you the links. That’s what I’m really interested in reading. That will have clout in a way that those who haven’t had doctoral brain research training can’t have. The responses at PT and the http://www.pornskeptics.com by Struthers and Reid have been measured and respectful. thanks.

    • July 26, 2013 at 12:04 pm

      It’s interesting how you keep asking for others opinions, and yet Reid’s response did not refute one aspect of Wilson’s post, as Wilson’s response clearly pointed out.

      Since you asked a research psychologist’s opinion, we have one. John Johnson’s expertise is evaluating research methodologies. Below is his comment found under Brian Mustanski’s Psychology Today “Interview” of Nicole Prause.

      A gap in logical inference

      Submitted by John A. Johnson, Ph.D. on July 19, 2013 – 11:35am.

      Mustanski asks, “What was the purpose of the study?” And Prause replies, “Our study tested whether people who report such problems [problems with regulating their viewing of online erotica] look like other addicts from their brain responses to sexual images.”

      But the study did not compare brain recordings from persons having problems regulating their viewing of online erotica to brain recordings from drug addicts and brain recordings from a non-addict control group, which would have been the obvious way to see if brain responses from the troubled group look more like the brain responses of addicts or non-addicts.

      Instead, Prause claims that their within-subject design was a better method, where research subjects serve as their own control group. With this design, they found that the EEG response of their subjects (as a group) to erotic pictures was stronger than their EEG responses to other kinds of pictures. This is shown in the inline waveform graph (although for some reason the graph differs considerably from the actual graph in the published article).

      So this group who reports having trouble regulating their viewing of online erotica has a stronger EEG response to erotic pictures than other kinds of pictures. Do addicts show a similarly strong EEG response when presented with their drug of choice? We don’t know. Do normal, non-addicts show a response as strong as the troubled group to erotica? Again, we do not know. We don’t know whether this EEG pattern is more similar to the brain patterns of addicts or non-addicts.

      The Prause research team claims to be able to demonstrate whether the elevated EEG response of their subjects to erotica is an addictive brain response or just a high-libido brain response by correlating a set of questionnaire scores with individual differences in EEG response. But explaining differences in EEG response is a different question from exploring whether the overall group’s response looks addictive or not. The Prause group reported that the only statistically significant correlation with the EEG response was a negative correlation (r=-.33) with desire for sex with a partner. In other words, there was a slight tendency for subjects with strong EEG responses to erotica to have lower desire for sex with a partner. How does that say anything about whether the brain responses of people who have trouble regulating their viewing of erotica are similar to addicts or non-addicts with a high libido?

  • July 26, 2013 at 4:13 pm

    Thanks for that link back to PT!

    So it sounds like to improve this study the next time around,researchers should…

    a. EEG test a control group of people who have no addictions

    b. EEG test a control group of certified alcoholics or crack cocaine addicts

    c. Use the entire SDI scale

    d. Only use homosexual men and show them gay sex pictures, or only use heterosexual men and show them hetero sex pictures

    e. prescreen the “d” group for self-reported sex addiction according to one of the accepted self-reported sex addiction scales

    f. maybe see if they can find two “sex” groups. One that self identifies as the live-sex-act component to their addiction, while the other self-identifies as screen porn addicts. Maybe there is a difference between men who look at porn and men who go to hookers or strip shows or sext to stranger partners.

    All that actually seems very achievable.

    Any other improvements that are crucial?

    • July 26, 2013 at 5:12 pm

      Those are all good points, and all would improve this study. But there were a few more points in the Wilson posts.

      Prause claimed that NOT finding correlations between the 4 questionnaire scores and EEG readings means that addiction is not a factor. Wilson pointed out that 2 of the questionnaires were suspect – the PCES and the SCS.

      He wrote an article about the PCES, which has a very long analysis by a “senior experimental psychologist”, who called it a psychometric nightmare.

      The sexual compulsivity scale (SCS) was designed in the early 90’s, and it’s questions are geared towards relationship sex, not Internet porn use. This means that so called sex addicts (Tiger Woods), would score very differently than a young college kid addicted to porn. Note that most of the subjects were college students.

      Another major point is the claim by prause and others that if you score high on the “sexual desire inventory”, that implies you have high sexual desire and not addiction. From Wilson’s post:

      The second major problem with this study is the implication that high sexual desire scores would indicate participants don’t have addiction. The concept that “high sexual desire” somehow rules out addiction is astounding. Its irrationality becomes clear if one considers hypotheticals based on other addictions.

      For example, does such logic mean that being morbidly obese, unable to control eating, and being extremely unhappy about it, is simply a “high desire for food?” Extrapolating further, must one conclude that alcoholics simply have a high desire for alcohol?

      Finally, the P300 EEG measurement is for attention or valence. As Wilson pointed out a cocaine addict viewing a picture of white powder on mirror would be universally arousing to a cocaine addict. Sexual arousal on the other hand involves multiple emotional an cognitive inputs, especially with each picture depicting a unique scenario with different porn stars.

      The point is that Prause is making broad sweeping claims on a single study. It took hundreds of brain studies and 20 years to have pathological gambling accepted as a true addiction (DSM5). Might caution, rather than manufactured headlines be more in order here?

      • July 26, 2013 at 6:15 pm

        That’s very interesting. So how would you operationalize Wilson’s points into pointers for the next study? What would be “g”, “h,” “i,” etc. on the list of suggestions? It seems like there is a different scale that you would used in addition to the SDI. Which one would that be, that meets your standard of validity? And what other concrete suggestions would be useful? Because it does seem so far like all these adjustments are eminently achievable!

  • July 28, 2013 at 5:35 pm

    Great post, Linda. You’re right that it makes sense to learn from the growing body of behavior addiction research instead of acting like sex is somehow “impossibly different” from other behaviors. Your readers may not know that there are already 50 addiction neuroscience studies on Internet addiction and videogaming addiction. It seems like those would be extremely relevant to Internet porn users, especially as many of the Internet addiction studies included porn use.

    A reliable, validated pre-screening test for Internet porn addiction seems like a first step. Here are a few thoughts on that topic, even though it’s tangential.

    Internet porn addiction, is, above all, an Internet addiction. Quite honestly, it belongs in a separate category from “sex addiction.” Its symptoms are different (frequent sexual performance problems, surprisingly severe withdrawal symptomsand evidence of tolerance ). It’s entirely computer-dependent, and it often weakens sexual performance with real partners.

    Porn-addiction/problematic-use rates thus far reported are quite possibly being minimized by the inadequacy of the existing screening tests. For example, the SCS (used in Prause’s infamous study) was developed for sex addiction, not Internet porn addiction. Many Internet addiction researchers use Young’s Internet Addiction Test, which evolved from a gambling addiction test. These tests don’t measure Internet porn addiction well, and especially not in young men (because the tests focus on relationship problems, etc.).

    Sadly, there doesn’t seem to be an entirely adequate, validated Internet-porn addiction screening test yet. Here’s the closest so far, created by a German team, but it’s based on the IAT:

    Here’s another wrinkle: Most guys don’t think they’re addicted no matter how much Internet porn they use (and might test accordingly) – and maybe some aren’t. What causes most guys (with porn-related symptoms) to realize they have a *porn *problem is sexual performance problems. Yet even when they start to suspect, they still have doubts that porn was the culprit–until they quit and their sexual performance problems gradually recede.

    I’m not aware of any existing Internet porn screening tests that address this reality at all. One result may be that the existing tools are not capturing the full range of today’s porn problem–by whatever label it is given.


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